Objective To analyze the clinical characteristics of coronary artery bypass graft sur-gery for elderly patients over the age of 70 years. Methods The clinical data of 232 elderly patients ( age﹥70 years)who underwent coronary artery bypass graft surgery were collected for analysis,including 208 cases of simple coronary artery bypass graft surgery,11 cases of additional mitral valve replacement or annuloplasty,6 cases of additional aortic valve replacement,1 case of additional mitral and aortic valve re-placement,5 cases of additional mediastinal or pericardial tumor resection and 1 case of additional aneu-rysm resection. Results There were eight cases of postoperative respiratory failure,six cases of poor wound healing,4 cases of secondary exploration for postoperative bleeding,2 cases of perioperative myocar-dial infarction,1case of third-degree atrioventricular block and 1 cases of cardiac tamponade. Deaths oc-curred in 2 cases. Conclusion For elderly patients over the age of 70 years,overall effect of coronary ar-tery bypass graft surgery is satisfied. It can improve the quality of life and prolong survival time.

OBJECTIVE：To investigate the general patterns and characteristics of ADRs to antibiotics and to guide rational drug use.METHODS：Using literature metrological method，1 230 cases developing drug adverse reactions to antibiotics,reported in Chinese literatures in the past 10 years,were analysed.RESULTS：ADRs to antibiotics of the 1 230 cases accounted for 46.19％ of all sorts of drug adverse reactions in the same time period.Among the antibiotics,β-lactam antibiotics were number one in kind(18 kinds),those happened most frequently were ampicillin(192 cases).The most frequent adverse reactions were damages to the skin and its appendages and the most serious reaction was anaphylactic shock,of which 76.15％ (83/109) was caused by β-lactams.Since the T cells are offen activated by drugs resulting in release of cytokines,which are the key to understand drug adverse reactions51.79％ (29/56)of renal dysfuncition was caused by aminoglycosis,therefore,attention should be paid to them.CONCLUSION：Attention to the rational use of antibiotics is essential,so as to reduce abuse use and damage to patients by irrational drug administration.

Objective To improve patients' satisfaction degree with nursing work,understand the psychological characteristics and demands of primipara during parturition period.Methods From January 2008 to January 2010,480 cases of primipara from department of obstetrics of our hospital were selected and divided into the observation group and the control group with 240 cases in each group.The control group adopted routine nursing,while the observation group was given psychological nursing and the Chinese medical nursing.The incidence of urinary retention and satisfaction degree of both groups were compared.Results The psychological characteristics and demands of primipara during primipara period showed no remarkable difference.The incidence of urinary retention was lower and satisfaction degree with nursing work was higher in the observation group than the control group.Conclusions The primiparas have anxiety because of fearing pain during parturition period,psychological nursing combined with Chinese medical nursing can reduce the occurrence of postpartum urinary retention and improve the satisfaction degree with nursing work.

“The second class” in medical college is an important carrier of humanities education.In order to give full play to its function,we must effectively rationalize the organization and management of medical humanities education institutions,not only to broaden the content and form of“ the second class”,but also to establish appropriate evaluation incentives.

Tubulointerstitial fibrosis is the final common pathway of most progressive renal diseases, and also is the pathological basis that leading to chronic renal failure. In recent years, the biological effect of tissue transglutaminase in the progressive tubulointerstitium fibrosis attracts more and more attention. Tissue transglutaminase belongs to a group of calcium-dependent mammalian enzymes that have the capacity to irreversibly cross-link proteins through the formation of e (γ-glutamyl)lysine bonds, and lead to the excessive deposition of extracellular matrix, then functions markedly in the tubulointerstitial fibrosis.

Combined operation and irradiation therapy has been performed on 22 patients with primary liver cancer in our hospital.All these patients were mal s.Age ranged from 15-49 years old with an average of 44.5. Histological dingnoais were. hepatocellular carcinoma in 21 cases and cholangiocarcinoma in 1 case. Seventeen (77.3%) patients were associated with liver cirrhosis, nineteen(86.4%)patients had positive AFP by counter- immunoelectrophoretic method.Clinically, 6 patients were stage I, 11 patients were stage II and 5 patients were stage III. The operative procedures consisted of liver resection in 17 patients (local resection 5, right hemihepatectomy 5, left lateral lobectomy 2, left hemihepatectomy 2, total right hepatectomy 2,and left medial lobectomy 1)and palliative operation in other 5 patients (hepatic artery ligation or embolization in 4 patients and hepatic artery infusion in 1 patient) .Radiotherapy comprised local or whole-liver irradiation with 60Co.Up to May 1983, 19 patients were followed-up, all of them survived more than 6 months.The 1, 2, 3, 4 year survival rates after treatment were 78.9%, 66.7%, 64.3% and 44.4% respectively with a median survival duration of 36 months.Data showed that the encouraging results of this method which were better than liver resection and radiotherapy or any other cmbined methods at present.

OBJECTIVE:To improve the monitoring capability and reporting rate of the adverse drug reactions (ADR) in Shanghai Pudong new area. METHODS: By a retrospective study,a total of 1 906 ADR reports collected from 2006 to 2008 in Shanghai Pudong new area were analyzed statistically. RESULTS: The ADR were more often induced by Chinese patent medicines and antibiotics and in which different organs or systems were involved,and 69.52% were induced intravenously. CONCLUSION: It is urgent to intensify clinic publicity and training on ADR,establish effective ADR monitoring system and thoroughly motivate medical staff's enthusiasm to raise the reporting rate of ADR.

5cm had the highet positive rate, while tumor with diameter

Objective To study the absorption and transport mechanism of ursolic acid(UA) by using Caco-2 monolayer model.Methods Evaluating the transport characteristic through studying whether P-glycoprotein(P-gp) transporter inhibitor Verapamil(VER) exists or not by using Caco-2 cell monolayer as an intestinal epithelial cell model and investigating the effects of uptake time,drug concentration,system temperature,and pH value of culture media on the uptake of UA.The drug concentration was measured by HPLC coupled with UV detector.Transport parameters and apparent permeability coefficients (P_(app)) were then calculated.Results In the concentration range of 10—40?mol/L,the uptake of UA by Caco-2 cell all linearly increased.The P_(app) of UA transported on Caco-2 cell monolayer model significantly changed when the specificity inhibitory of P-gp was added to model and the apparent permeability ratio decreased from 3.445 to 1.386.Conclusion The intestinal absorption of UA is passive diffusion as the dominating process and active transportation mediated by P-gp transporter in Caco-2 cell monolayer model.

Purpose;To observe curative effect and side reaction ,histopathology change of dose - dense combinated pharmorubicin with paclitaxel in advanced breast cancer treatment. Methods ;38 patients with advanced breast cancer diagnosed by pathology, which had e-valuation index, pharmorubicin 50mg/m2 ,d1 , intravenous injection,paclitaxel 175mg/m2,d2,intravenous injection,every 2 weeks as 1 course of treatment,after accepted 2 - 4 course of treatment,all patients were evaluated. Results: All patients were followed up,clinical complete remission( CR) 10. 5% , clinical partial remission 71. 1% , total effective rate 81. 6% . effective rate in patents of initial treatment was much higher than that in patients of retreatmen; effective rate in patents of III stage also was much higher than that in patients of IV stage; low leucocyte and Neutropenia appeared III ,IV side reaction,occupying respectively 63.2% and 71. 1% ;7.9% patients febricity owing to low leucocyte were cured by G - CSF and antibiotics,all patients successfully accomplish chemotherapy. Other side reaction,for instance thrombocytopenia.anaemia,nausea and vomiting etc,mostly displayed I , II toxic reaction,but they can be tolerated. After chemotherapy,cancer cells degeneration . cellular necrosis . retrogression and interstitial fibrosis .inflammatory cell infiltration are obviously changed. Conclusion: dose -dense chemotherapy combinated pharmorubicin with paclitaxel in advanced breast cancer treatment, remission rate was much higher and remission rate can be tolerated.